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目的:探讨孕期骨营养监测指导对孕产妇骨健康的影响。方法:将472例孕妇根据早孕建册日期随机分成干预组和对照组,两组在年龄、体质指数(BMI)、孕周、文化程度、职业、家庭人均月收入等方面的差异均无统计学意义(P>0.05)。干预组从孕20周左右至产后42 d接受骨营养监测指导,包括定期超声骨密度检测、24 h膳食调查及指导、科学补钙指导以及常规孕产期保健指导。对照组接受常规孕产期保健,定期监测超声骨密度。结果:①干预组(-0.83±0.56)和对照组(0.77±0.51)在孕中期的骨密度T值均比孕早期低,差异具有统计学意义(P<0.001),但两组孕中期的骨密度差异无统计学意义(t=-1.08,P=0.129);②干预组孕晚期骨密度T值(-0.78±0.63)较对照组(-1.03±0.57)高,差异有统计学意义(t=4.49,P<0.001);干预组产后42 d骨密度T值(-0.68±0.94)较对照组(-1.32±0.81)高,差异具有统计学意义(t=7.90,P<0.001)。对照组的骨密度在孕期及产褥期呈下降趋势,而干预组未呈现明显的下降趋势,差异具有统计学意义(P<0.001);③干预组难产发生率(11.4%)低于对照组,差异有统计学意义。结论:孕产期进行骨营养监测指导可有效改善孕产妇骨健康状况。
Objective: To investigate the effect of pregnancy monitoring guidance on maternal bone health. Methods: 472 pregnant women were randomly divided into intervention group and control group according to the date of first trimester pregnancy. There was no significant difference in age, BMI, gestational age, educational level, occupation, monthly per capita income among the two groups Significance (P> 0.05). Intervention group from 20 weeks of pregnancy to 42 days postpartum bone nutrition monitoring guidance, including regular ultrasound bone mineral density testing, 24-hour dietary investigation and guidance, scientific calcium guidance and routine guidance during pregnancy. The control group received routine maternal health care and regularly monitored ultrasound bone mineral density. Results: ① The T value of BMD in the intervention group (-0.83 ± 0.56) and the control group (0.77 ± 0.51) were lower than those in the first trimester, the difference was statistically significant (P <0.001) (T = -1.08, P = 0.129). ②There was a significant difference in T value (-0.78 ± 0.63) between the intervention group and the control group (-1.03 ± 0.57) t = 4.49, P <0.001). The bone mineral density (T) of the intervention group at 42 d after birth was significantly higher than that of the control group (-1.32 ± 0.81), the difference was statistically significant (t = 7.90, P <0.001). The BMD of the control group showed a decreasing trend during pregnancy and puerperium, while the intervention group did not show a significant downward trend, the difference was statistically significant (P <0.001); ③ The incidence of dystocia in the intervention group (11.4%) was lower than that of the control group There is statistical significance. Conclusion: Guidance of monitoring bone nutrition during pregnancy and motherhood can effectively improve the status of maternal bone health.